Objectives: To investigate whether adjuvant concurrent chemotherapy with pelvic intensitymodulated radiotherapy (IMRT) improves the outcome of patients with early-stage cervical cancer with intermediate risk factors (IRFs) compared with IMRT alone.Methods: This study included a cohort of 244 women from January 2012 to October 2023 who underwent radical hysterectomy along with pelvic lymph node dissection (PLND) for stage IB-IIA cervical cancer with IRFs.One hundred thirty-nine patients were postoperatively treated with pelvic IMRT (45.0-50.4Gy) and adjuvant concurrent chemoradiotherapy (CCRT) (weekly cisplatin or weekly or triweekly combination of paclitaxel and cisplatin).One hundred five patients were treated with pelvic IMRT alone.The significance of clinical parameters, overall survival (OS), and recurrence-free survival (RFS) of each arm were analyzed.Results: The median follow-up period was 61.2 months, with a range spanning from 6.3 to 144.4 months.The 5-year OS rates in the patients in the radiotherapy (RT) and CCRT arms were 96.7% and 94.4%, respectively (p=0.271).Five-year RFS was 88.1% in the RT arm and 86.9% in the CCRT arm (p=0.740).Multivariate analysis identified adenocarcinoma (AC) histology as the only significant prognostic factor affecting OS and RFS. Conclusion:This study demonstrates that even in the era of IMRT, CCRT is not more effective than RT alone in patients with stage IB-IIA cervical cancer with IRFs following radical hysterectomy with PLND.
Wang et al. (Thu,) studied this question.